Stage Of Disease Research Articles

Phage display–based acoustic biosensor for early cancer diagnosis

The probability of a cancer patient being cured depends largely on the stage of disease at the time of diagnosis. It is therefore very important to develop methods for early cancer diagnosis that would allow screening of a large number of samples in a short time. Here, a unique method is presented for rapid immunodetection of heat shock proteins (HSPs). The method uses a compact acoustic sensor based on a lateral-field piezoelectric resonator and specific phage antibodies. The phage antibodies for the first time were developed against HSPs of P3X63Ag8.653 mouse myeloma cells. The change in the electric impedance modulus of resonator after recording of phage antibody–HSP interaction served as the analytic signal with analysis time less than 5 min. Antibody-HSP interaction confirmed by microscopic analysis and flow cytometry. This study establishes a new strategy for early cancer diagnosis by compact acoustic sensor with phage antibodies as sensing element. The results can be used to develop a noninvasive rapid method of early cancer diagnosis on basis of HSP determination and to control the content of HSPs in the monitoring of tumor therapy.

340. THE IMPACT OF OBESITY ON SURGICAL OUTCOMES AFTER ESOPHAGECTOMY FOR CANCER IN SWEDEN

Abstract Background Global obesity rates continue to rise and are closely linked to an increase in esophageal adenocarcinoma. While obesity is associated with an increased risk of postoperative complications, its influence on long-term survival is less clear. Some studies suggest that obese patients have poorer outcomes due to higher comorbidity rates, while others indicate comparable or even better survival, possibly due to better nutritional reserves. This study aims to investigate whether obesity affects the survival and risk of postoperative complications in a national cohort of esophageal cancer patients. Methods This retrospective population-based register study included all individuals who underwent esophageal resection between 2006 and 2018 in Sweden. Data were extracted from the national quality registry for esophageal and gastric cancer (NREV). The cohort was grouped based on body mass index (BMI) into underweight (BMI < 20), normal (BMI 20-25), overweight (BMI 25-30), and obese (BMI > 30). Kaplan-Meier was used for survival analysis, and logistic regression and Cox regression were used for adjusted analyses (adjusting for sex, age, marital status, education level, Charlson comorbidity index score, histopathology, disease stage, and year of diagnosis). Results In total, 1742 individuals (79.9% males, mean age 66) were included, of whom 242 (13.9%) were obese. Obese individuals had more comorbidities at surgery, more commonly had adenocarcinoma, and underwent surgery more frequently in the later time period. The risk of surgical complications (e.g., anastomotic leak, bleeding) for obese individuals was not increased compared to those with normal weight (OR: 0.83 [0.56-1.21]), but an increased risk of non-surgical complications (e.g., pneumonia, cardiopulmonary events) was observed (OR: 1.78 [1.22-2.60]). The risk of death of any cause was decreased in obese individuals compared to those with normal weight (HR: 0.74 [0.58-0.95]), resulting in superior overall survival. Conclusion Despite the presence of more comorbidities among obese individuals undergoing esophagectomy, their risk of surgical complications remained comparable to those with normal weight. However, obese individuals exhibited a heightened susceptibility to other postoperative complications. Surprisingly, obese individuals demonstrated an improved overall survival at 5 years compared to those with normal weight.

Neoadjuvant pembrolizumab plus chemotherapy followed by adjuvant pembrolizumab compared with neoadjuvant chemotherapy alone in patients with early-stage non-small-cell lung cancer (KEYNOTE-671): a randomised, double-blind, placebo-controlled, phase 3 trial.

At the first interim analysis of the KEYNOTE-671 trial, adding perioperative pembrolizumab to neoadjuvant chemotherapy significantly improved event-free survival in participants with early-stage non-small-cell lung cancer (NSCLC). We report overall survival and health-related quality of life outcomes from the second interim analysis. KEYNOTE-671 was a global phase 3 trial done at 189 medical centres. Eligible participants (aged ≥18 years) with resectable stage II, IIIA, or IIIB (N2) NSCLC were randomly assigned (1:1) to four cycles of neoadjuvant pembrolizumab (200 mg administered intravenously every 3 weeks) plus cisplatin-based chemotherapy followed by surgery and 13 cycles of adjuvant pembrolizumab (200 mg administered intravenously every 3 weeks) or to four cycles of neoadjuvant placebo (administered intravenously every 3 weeks) plus cisplatin-based chemotherapy followed by surgery and 13 cycles of adjuvant placebo (administered intravenously every 3 weeks). Randomisation was done centrally using an interactive response technology system and was stratified by disease stage, PD-L1 expression, histology, and geographical region in blocks of four. Participants, investigators, and sponsor personnel were masked to treatment assignments; local pharmacists were unmasked to support treatment preparation. The dual primary endpoints were overall survival and event-free survival evaluated in the intention-to-treat population. This study is registered at ClinicalTrials.gov, NCT03425643, and is ongoing but closed to enrolment. Between May 11, 2018, and Dec 15, 2021, 797 participants were randomly assigned to the pembrolizumab group (n=397) or the placebo group (n=400). Median study follow-up at the second interim analysis was 36·6 months (IQR 27·6-47·8). 36-month overall survival estimates were 71% (95% CI 66-76) in the pembrolizumab group and 64% (58-69) in the placebo group (hazard ratio 0·72 [95% CI 0·56-0·93]; one-sided p=0·0052; threshold, one-sided p=0·0054). Median event-free survival was 47·2 months (95% CI 32·9 to not reached) in the pembrolizumab group and 18·3 months (14·8-22·1) in the placebo group (hazard ratio 0·59 [95% CI 0·48-0·72]). In the as-treated population, grade 3-5 treatment-related adverse events occurred in 179 (45%) of 396 participants in the pembrolizumab group and in 151 (38%) of 399 participants in the placebo group. Treatment-related adverse events led to death in four (1%) participants in the pembrolizumab group and three (1%) participants in the placebo group. The significant overall survival benefit of neoadjuvant pembrolizumab plus chemotherapy followed by adjuvant pembrolizumab compared with neoadjuvant chemotherapy alone coupled with a manageable safety profile support the use of perioperative pembrolizumab in patients with resectable, early-stage NSCLC. Merck Sharp & Dohme, a subsidiary of Merck & Co, Rahway, NJ, USA.

1H Nuclear Magnetic Resonance Spectroscopy Reveals Changes in Metabolic Phenotype Associated with Disease Stage in Patients with Chronic Venous Disease

1H Nuclear Magnetic Resonance Spectroscopy Reveals Changes in Metabolic Phenotype Associated with Disease Stage in Patients with Chronic Venous Disease

Ocular adnexal lymphoma - a retrospective study and review of the literature.

To review the characteristics of all Slovenian patients with ocular adnexal lymphoma (OAL) in the period of 24 years with the aim of evaluating demographic data, lymphoma location and type, disease stage, treatment modality, local control rate and survival rate. All patients with histologically diagnosed OAL in the main tertiary centre of Slovenia, Eye Hospital, University Medical Centre Ljubljana, who were treated at Institute of Oncology Ljubljana were included in the study. Patients' data were collected from October 1995 through April 2019. Seventy-four patients were included in the study having a median age of 68 years at diagnosis. The majority of lymphomas were of B-cell origin (98.6%). The most frequent type was the extranodal marginal zone B-cell lymphoma (MALT) (71.6%). Orbital lymphomas were diagnosed in 56 cases (75.7%) and conjunctival in 18 cases (24.3%). Ocular manifestation was the first sign of the disease in 78.4% of patients and in 67.6% of patients ocular adnexa were the only disease location. Fifty-one patients (68.9%) were treated with radiotherapy, 7 patients (9.4%) with systemic treatment, 5 patients (6.8%) with combined radiotherapy and systemic treatment and in 11 patients, biopsy and active surveillance strategy was applied (14.9%). Local control of the disease was achieved in 96.6% of treated patients. Median overall survival of the whole study group has not been reached yet. Five-year overall survival rate was 80.1% (95% CI 68.1% - 88.5%) and 5-year lymphoma specific survival rate was 87.2% (95% CI 83.2%-91.2%). OALs comprise a group of heterogeneous diseases with variable outcomes depending predominately on the patient's age and lymphoma type, with low grade lymphomas carrying good prognosis even in elderly patients.

Budget impact models for lung cancer interventions: A systematic literature review.

Budget impact models (BIMs) forecast the financial implications of adopting new technologies and the potential need for budget reallocation, thus playing a crucial role in reimbursement decisions. Despite the importance of accurate forecasts, studies indicate large discrepancies between estimates and reality. We are developing an artificial intelligence-based clinical decision tool to identify patients with non-small cell lung cancer who are most likely to benefit from immunotherapy. To evaluate the budgetary implications and describe a systematic literature review of published lung cancer BIMs. We searched PubMed and EMBASE for studies published between 2010 and 2023 that include BIMs that describe lung cancer interventions. Forward and backward reference searches were performed for all qualifying studies. We extracted author and publication year, country, interventions, disease stages, time horizon, analytical perspective, modeling methods used, types of costs included, sensitivity analyses conducted, and data sources used. We then evaluated adherence to the Professional Society for Health Economics and Pharmacoeconomics Research best-practice guidelines. A total of 25 BIMs were identified, spanning 14 different countries. Model structure could not be ascertained definitively for nearly half of the models. The cost calculator approach was most common among the others. Time horizons ranged from 1 to 5 years, in line with recommendations. Most models compared drugs, 4 compared nondrug interventions, and 7 compared diagnostic technologies. Assumptions about market uptake were poorly documented and poorly motivated. Inclusion of cancer-related costs was rare. Adherence to best practices was variable and did not appear to improve over time. The number of published BIMs for lung cancer exceeded expectations. There were modest trends toward publication frequency and model quality over time. Our analysis revealed variability across the models, as well as their adherence to best practices, indicating substantial room for improvement. Although none of the models were individually suitable for the purpose of evaluating an artificial intelligence-based treatment selection tool, some models provided valuable insights.

Cost-Sensitive Weighted Contrastive Learning Based on Graph Convolutional Networks for Imbalanced Alzheimer's Disease Staging.

Identifying the progression stages of Alzheimer's disease (AD) can be considered as an imbalanced multi-class classification problem in machine learning. It is challenging due to the class imbalance issue and the heterogeneity of the disease. Recently, graph convolutional networks (GCNs) have been successfully applied in AD classification. However, these works did not handle the class imbalance issue in classification. Besides, they ignore the heterogeneity of the disease. To this end, we propose a novel cost-sensitive weighted contrastive learning method based on graph convolutional networks (CSWCL-GCNs) for imbalanced AD staging using resting-state functional magnetic resonance imaging (rs-fMRI). The proposed method is developed on a multi-view graph constructed by the functional connectivity (FC) and high-order functional connectivity (HOFC) features of the subjects. A novel cost-sensitive weighted contrastive learning procedure is proposed to capture discriminative information from the minority classes, encouraging the samples in the minority class to provide adequate supervision. Considering the heterogeneity of the disease, the weights of the negative pairs are introduced into contrastive learning and they are computed based on the distance to class prototypes, which are automatically learned from the training data. Meanwhile, the cost-sensitive mechanism is further introduced into contrastive learning to handle the class imbalance issue. The proposed CSWCL-GCN is evaluated on 720 subjects (including 184 NCs, 40 SMC patients, 208 EMCI patients, 172 LMCI patients and 116 AD patients) from the ADNI (Alzheimer's Disease Neuroimaging Initiative). Experimental results show that the proposed CSWCL-GCN outperforms state-of-the-art methods on the ADNI database.

Clinical Implications of Left Ventricular Apex Mechanics in Patients with Apical Hypertrophic Cardiomyopathy

Apical hypertrophic cardiomyopathy (ApHCM) is a unique disease with pathological hypertrophy mainly at the left ventricular (LV) apex. Although previous studies have indicated apical dysfunction in ApHCM, how apical mechanics change during disease progression has not been thoroughly examined. We aimed to characterize the mechanics of the LV apex in ApHCM patients at different disease stages and explore the clinical significance of these alterations. 104 ApHCM patients were divided into 3 subtypes based on LV apical maximum wall thickness (AMWT) and extent of hypertrophy: relative-type (isolated apical hypertrophy with AMWT <15 mm), pure-type (isolated apical hypertrophy with AMWT ≥15 mm), and mixed-type (both apical and midventricular hypertrophy with AMWT ≥15 mm). Two-dimensional speckle-tracking echocardiography was used to analyze LV segmental strain, global strain, and twist. Comparisons of these parameters were performed among ApHCM subtypes and 30 healthy controls. Logistic regression and Cox proportional hazard regression analyses were employed to explore associations between myocardial mechanics and clinical indicators. A composite outcome of new-onset atrial fibrillation, heart failure hospitalization, myectomy, and all-cause mortality was assessed. Even in relative ApHCM patients, apical longitudinal strain (LS), circumferential strain (CS), and radial strain (RS) were significantly impaired compared to controls (LS: -14.6±4.1% vs.-20.0±1.7%, p=0.001; CS: -19.6±2.5% vs.-25.6±3.7%, p=0.002; RS: 26.6±7.4% vs. 35.6±11.1%, p=0.026), while apical rotation and LV twist remained unchanged. In patients with greater apical hypertrophy (mixed and pure patients), apical LS and RS were more abnormal. Moreover, apical rotation showed significant reductions compared to relative-type patients. After adjusting for clinical and myocardial mechanical parameters, apical rotation was independently associated with NYHA class ≥ II (odds ratio =0.81, 95% confidence interval [CI]: 0.66-0.99, p=0.036) and the composite outcome (hazard ratio =0.82, 95% CI: 0.73-0.91, p=0.001). Relative ApHCM demonstrates apical dysfunction but sparing of apical rotation, which was abnormal in more extensive phenotypes. LV apex mechanics were closely related to clinical patterns, with apical rotation correlated with both NYHA class ≥ II and clinical events.

A novel prognostic scoring system for AML patients undergoing allogeneic hematopoietic stem cell transplantation with real world validation

ObjectivesThis study aims to develop a robust predictive model for survival in AML patients undergoing allo-HSCT. MethodsIt was performed a retrospective analysis of 336 AML patients who underwent allo-HSCT at Peking University First Hospital between September 2003 and March 2023. Univariable and multivariable Cox regression analyses were conducted to determine hazard ratios (HR) for overall survival. A predictive model was developed based on multivariable analysis results. Internal validation was carried out through bootstrap resampling, and the model’s performance was assessed using the Concordance Index (C-index), Receiver Operating Characteristics (ROC) curve, calibration plots, and Decision Curve Analysis (DCA). ResultsOur prognostic model, which includes age, disease stage, donor/recipient gender, mononuclear cell counts, and the Hematopoietic Cell Transplantation Comorbidity Index (HCT-CI), effectively stratified patients into low-risk and high-risk groups. The two groups showed significant differences in overall survival (P<0.0001), disease-free survival (P<0.0001), non-relapse mortality (NRM) (P<0.0001), and relapse rates (P=0.08). The model achieved a C-index of 0.71. Calibration plots and DCA confirmed strong alignment between predicted and observed outcomes. Subgroup analysis revealed that overall survival was significantly lower in the high-risk group compared to the low-risk group in both measurable residual disease (MRD) negative and MRD positive subgroups (P=0.015 for both). ConclusionThe developed prognostic model, which integrates comprehensive disease and patient characteristics, enhances risk stratification for AML patients undergoing allo-HSCT. This model effectively stratifies risk in both MRD-negative and MRD-positive subgroups and may facilitate more informed MRD-based treatment decisions.

Durvalumab With or Without Tremelimumab in Combination With Chemotherapy in First-Line Metastatic NSCLC: Five-Year Overall Survival Outcomes From the Phase 3 POSEIDON Trial

IntroductionThe primary analysis (median follow-up 34.9 mo across all arms) of the phase 3 POSEIDON study revealed a statistically significant overall survival (OS) improvement with first-line tremelimumab plus durvalumab and chemotherapy (T+D+CT) versus CT in patients with EGFR/ALK wild-type metastatic NSCLC (mNSCLC). D+CT had a trend for OS improvement versus CT that did not reach statistical significance. This article reports prespecified OS analyses after long-term follow-up (median >5 y). MethodsA total of 1013 patients were randomized (1:1:1) to T+D+CT, D+CT, or CT, stratified by tumor cell programmed cell death ligand-1 (PD-L1) expression (≥50% versus <50%), disease stage (IVA versus IVB), and histology (squamous versus nonsquamous). Serious adverse events were collected during follow-up. ResultsAfter a median follow-up of 63.4 months across all arms, T+D+CT had sustained OS benefit versus CT (hazard ratio [HR] = 0.76, 95% confidence interval [CI]: 0.64–0.89; 5-y OS: 15.7% versus 6.8%). OS improvement with D+CT versus CT (HR = 0.84, 95% CI: 0.72–1.00; 5-y OS: 13.0%) was consistent with the primary analysis. OS benefit with T+D+CT versus CT remained more pronounced in nonsquamous (HR = 0.69, 95% CI: 0.56–0.85) versus squamous (HR = 0.85, 95% CI: 0.65–1.10) mNSCLC. OS benefit with T+D+CT versus CT was still evident regardless of PD-L1 expression, including patients with PD-L1 tumor cell less than 1%, and remained evident in STK11-mutant (nonsquamous), KEAP1-mutant, and KRAS-mutant (nonsquamous) mNSCLC. No new safety signals were identified. ConclusionsAfter a median follow-up of more than 5 years, T+D+CT had durable long-term OS benefit versus CT, supporting its use as first-line treatment in mNSCLC, including in patient subgroups with harder-to-treat disease.

Obesity-Related Glomerulopathy: Epidemiology, Pathogenesis, and Current Treatments

Obesity-related glomerulopathy (ORG) is a kidney disease characterized by glomerulomegaly with or without focal segmental glomerulosclerosis. With the increase in worldwide obesity rates, the number of ORG patients has also risen rapidly. Approximately 10% of ORG patients have been found to progress to the end stage of renal disease 6.2 years after diagnosis. The pathogenesis of ORG is complex, involving altered renal hemodynamics, activation of the renin–angiotensin–aldosterone system, insulin resistance, and abnormal lipid metabolism and adipokines. Despite the numerous strategies to lose weight as treatment for ORG, ranging from lifestyle and diet changes to bariatric surgery and medications, approved and marketed weight-loss drugs often have potential side effects and perform below expectations. Recently, new glucose-lowering drugs that also reduce body weight and improve kidney function have garnered attention. In particular, several large clinical trials have confirmed the efficacy and safety of sodium–glucose cotransporter 2 inhibitors and glucagon-like peptide-1 receptor agonists in reducing weight and preserving kidney function. This article provides a brief review of the epidemiology, pathogenesis, and treatment strategies of ORG.

Optimized Fast Non-Singular Integral Terminal Sliding Mode Control of Immune Response and HCMV Infection of Renal Transplant Recipient

Kidneys are the most commonly transplanted organs, and renal transplant is the best treatment for patients with advanced stages of renal disease. Immunosuppressive drugs are used after renal transplant to prevent the body from rejecting the transplanted kidney and ensure its proper kidney functioning. However, suppression of the immune system increases the risk of viral infections and other complications. Therefore, careful monitoring and management of immunosuppressive and antiviral drugs are essential for the success of the transplants. This article presents a hybrid fast non-singular integral terminal sliding mode control technique to adjust the efficacies of these drugs in renal transplant recipients, ensuring successful transplants and preventing viral infections. The proposed strategy tracks system trajectories to reference values and adjusts the treatment plan accordingly. The Lyapunov stability theorem is used to prove the asymptotic stability of the closed-loop system. Several simulation studies are conducted in MATLAB/Simulink environment to evaluate the performance of the proposed control technique in maintaining a balance between over-suppression and under-suppression. Genetic Algorithm is used to optimize the gain values to further improve the performance of the proposed control technique. Its performance is compared with two other variants of terminal sliding mode controllers to demonstrate its effectiveness against them.

Dietary total antioxidant capacity in relation to disease severity and risk of mortality in cirrhosis; results from a cohort study

Liver Cirrhosis, defined as the final stage of chronic liver disease, may become more prevalent in the lower level of body defense against oxidation and inflammation. Therefore, we assessed the association of dietary total antioxidant capacity (DTAC) with the severity and mortality of cirrhosis in a cohort study. 120 newly diagnosed cirrhosis patients from Tehran, Iran, participated in this study. The patients’ habitual diet was assessed using a 168-item validated food frequency questionnaire. Both ferric-reducing antioxidant potential (FRAP) and oxygen radical scavenging capacity (ORAC) methods were computed to achieve DTAC scores. The association between DTAC with disease severity and mortality was estimated by multivariate linear regression and cox proportional hazards regression models. Dietary total antioxidant capacity-ORAC had a significant inverse association with disease severity in both crude and adjusted models (P for trend: <0.001 and 0.016 respectively). The risk of mortality in the first and second tertiles of ORAC was 5.56 (95 % CI: 2.25–13.75; P = 0.002) and 3.20 (95 % CI: 1.25–8.19; P = 0.015) higher than those in the third category, respectively. In conclusion, a higher antioxidant capacity of diet is associated with less disease severity and mortality risk in cirrhosis.

A prediction model of dementia conversion for mild cognitive impairment by combining plasma pTau181 and structural imaging features.

The early stages of Alzheimer's disease (AD) are no longer insurmountable. Therefore, identifying at-risk individuals is of great importance for precise treatment. We developed a model to predict cognitive deterioration in patients with mild cognitive impairment (MCI). Based on the Alzheimer's Disease Neuroimaging Initiative (ADNI) database, we constructed models in a derivation cohort of 761 participants with MCI (138 of whom developed dementia at the 36th month) and verified them in a validation cohort of 353 cognitively normal controls (54 developed MCI and 19 developed dementia at the 36th month). In addition, 1303 participants with available AD cerebrospinal fluid core biomarkers were selected to clarify the ability of the model to predict AD core features. We assessed 32 parameters as candidate predictors, including clinical information, blood biomarkers, and structural imaging features, and used multivariable logistic regression analysis to develop our prediction model. Six independent variables of MCI deterioration were identified: apolipoprotein E ε4 allele status, lower Mini-Mental State Examination scores, higher levels of plasma pTau181, smaller volumes of the left hippocampus and right amygdala, and a thinner right inferior temporal cortex. We established an easy-to-use risk heat map and risk score based on these risk factors. The area under the curve (AUC) for both internal and external validations was close to 0.850. Furthermore, the AUC was above 0.800 in identifying participants with high brain amyloid-β loads. Calibration plots demonstrated good agreement between the predicted probability and actual observations in the internal and external validations. We developed and validated an accurate prediction model for dementia conversion in patients with MCI. Simultaneously, the model predicts AD-specific pathological changes. We hope that this model will contribute to more precise clinical treatment and better healthcare resource allocation.

Dedifferentiation- and aging-induced loss of mechanical contractility and polarity in vascular smooth muscle cells: Heterogeneous changes in macroscopic and microscopic behavior of cells in serial passage culture

Dedifferentiation and aging of vascular smooth muscle cells (VSMCs) are associated with serious vascular diseases, such as arteriosclerosis and aneurysm. However, how cell dedifferentiation and aging affect cellular mechanical behaviors at the single-cell and intracellular structure levels remains unclear. An in-depth understanding of these interactions is extremely important for understanding the mechanism underlying VSMC mechanical integrity and homeostatic regulation of vascular walls. Herein, we systematically investigated changes in VSMC morphology, structure, contractility, and motility during dedifferentiation and aging induced by serial passage culture using traction force microscopy with elastic micropillar substrates, laser nanodissection of cytoskeletons, confocal fluorescence microscopy, and atomic force microscopy. We found that VSMC dedifferentiation started in the middle stage of serial passage culture, accompanied by a transient cell spreading in the cell width and decrease in contractile protein expression. Dedifferentiated VSMCs showed a significant decrease in the contraction and stiffness of individual actin stress fibers; however, their overall cell traction forces were maintained. Simultaneously, a significant increase in cell motility and the number of actin fibers was observed in dedifferentiated VSMCs, which may be associated with the enhancement of cell migration and disruption of cell/tissue integrity during the early stage of vascular diseases. As cell senescence progressed in the later stage of serial passage culture, VSMCs displayed reduced cell spreading and migration with decrease in the overall cell traction forces and drastic reduction in mechanical polarity of cell structures and forces. These results suggested that cell senescence causes loss of mechanical contractility and polarity in VSMCs, which may be an important factor in vascular disease progression. The experimental systems established in this study can be powerful tools for understanding the mechanisms underlying cellular dedifferentiation and aging from a biomechanical perspective.

Enhancing stroke prediction using the waikato environment for knowledge analysis

&lt;p&gt;State-of-the-art data mining tools incorporate advanced machine learning (ML) and artificial intelligence (AI) models, and it is widely used in classification, association rules, clustering, prediction, and sequential models. Data mining is important for the process of diagnosing and predicting diseases in the early stages, and this contributes greatly to the development of the health services sector. This study utilized classification to predict the stroke of a sample of the patient dataset that was taken from Kaggle. The classification model was created using the data mining program waikato environment for knowledge analysis (WEKA). This data mining tool helped identify individuals most at risk of stroke based on analysis of features extracted from the patient’s dataset. These features were used in classification processes according to the naive Bayes (NB), random forest (RF), support vector machine (SVM), and multi-layer perceptron (MLP) algorithms. Analysis of the classification results of the previous algorithms showed that the SVM outperformed other algorithms in terms of accuracy (94.4%), sensitivity (100%), and F-measure (97.1%). However, the NB algorithm had the best performance in terms of precision (95.7%).&lt;/p&gt;

The History and the Structure of Hospices in Uzbekistan

In the modern world, there is a constant increase in the number of patients suffering from incurable forms of diseases in the terminal stage of development. This trend actualizes the study of palliative care, which is a special area of social and medical care for terminally ill people. Palliative care is an integrated part of cancer patient care. However, the situation in palliative care in Uzbekistan is very critical. Implementing palliative care and hospice into medicine began in 2017 in Tashkent, Uzbekistan. The first Children’s Hospice -Taskin was opened in 2022 in Tashkent, Uzbekistan. Despite the fact that 2 years have passed since the opening of the hospice in the Republic of Uzbekistan, the concept of hospice has not yet formed in the minds of the population, there is still an idea that people perceive the concept of “hospice” as a house of death. This article is intended to study the history and structure of palliative care in Uzbekistan and study the perception of hospice among the population.

RESTING-STATE FUNCTIONAL CONNECTIVITY ABNORMALITIES IN SUBJECTIVE COGNITIVE DECLINE: A 7T MRI STUDY

Resting-state functional connectivity (FC) MRI is sensitive to brain changes in Alzheimer’s disease in preclinical stages, however studies in persons with subjective cognitive decline (SCD) have reported conflicting findings, and no study is available at 7T MRI. In this study, we investigated FC alterations in sixty-six participants recruited at the Geneva Memory Center (24 controls, 14 SCD, 28 cognitively impaired [CI]). Participants were classified as SCD if they reported cognitive complaints without objective cognitive deficits, and underwent 7T fMRI to assess FC in canonical brain networks and their association with cognitive/clinical features. SCD showed normal cognition, a trend for higher depressive symptoms, and normal AD biomarkers. Compared to the other two groups, SCD showed higher FC in frontal default mode network (DMN) and insular and superior temporal nodes of ventral attention network (VAN). Higher FC in the DMN and VAN was associated with worse cognition but not depression, suggesting that hyper-connectivity in these networks may be a signature of age-related cognitive decline in SCD at low risk of developing AD.

1125P Accuracy of PET-CT to assess extent of nodal disease in clinical stage III melanoma

1125P Accuracy of PET-CT to assess extent of nodal disease in clinical stage III melanoma

Predictors of cerebral microbleeds in patients with autosomal dominant polycystic kidney disease

ObjectivesIndividuals with autosomal dominant polycystic kidney disease (ADPKD) can present with vascular abnormalities, including intracranial aneurysms. However, whether ADPKD is associated with cerebral small-vessel disease, such as cerebral microbleeds (CM), remains unclear. The study analyzes the prevalence of CM and the associated clinical and radiological factors in patients with ADPKD. MethodsThe retrospective study enrolled 140 consecutive patients with ADPKD from July 2014 to May 2023. Brain MRIs were analyzed for the presence of CM with susceptibility-weighted imaging (SWI), which were categorized based on lesion location (lobar, deep, or infratentorial). ResultIn this study, the prevalence of CM is 26.4%. Chronic kidney disease (CKD) stage (odds ratio [OR]: 1.40, 95% confidence interval [CI]: 1.04–1.88, p = 0.027) and leukoaraiosis grade (OR: 3.29, 95% CI: 1.43–7.56, p = 0.005) were strongly associated with CM. Additionally, both CKD stage (OR: 1.48, 95% CI: 1.06–2.07, p = 0.023) and leukoaraiosis grade (OR: 2.81, 95% CI: 1.30–6.05, p = 0.008) were associated with lobar microbleeds, whereas only leukoaraiosis grade was also related to deep (OR: 9.00, 95% CI: 3.06–26.44, p < 0.001) and infratentorial (OR: 2.48, 95% CI: 1.10–5.61, p = 0.029) microbleeds. The prediction model based on age, CKD stage and leukoaraiosis grade had diagnostic performance with area under curve: 0.804, 0.688, 0.697, respectively. ConclusionWe recommend that patients with ADPKD who are aged 58 or older, and who have CKD of at least stage 3, undergo brain MRI for detection of CM.